EverythingHealth is designed to address the rapid changes in Science, Medicine, Health and Healing in the 21st Century. This site will sift through the vast amount of confusing data and simplify issues that are of interest to everyone interested in a healthy life and longevity. The writings on EverythingHealth are entirely my own views and opinions.

Thursday, January 21, 2016

My under 30 year old hairdresser mentioned to me that she was having a "Dry January". I had never heard that term and she explained that she wanted to be bikini ready for a trip to Maui so she was having no alcohol for the month. According to a UK magazine called New Scientist, she is on the right track.

According to an article in National Public Radio Online, the staff at the magazine used themselves as guinea pigs and swore off booze to see what the health benefits would be. Of the 14 staff members, 10 of them gave up alcohol for 5 weeks and 4 continued to drink as they usually do. Their drinking patterns varied from a "low" of 8 bottles of beer to a shocking 64 beers a week. (Those Brits do like their pubs!)

They analyzed the results of lifestyle questionnaires, ultrasounds and blood samples and found some remarkable differences in just that short period of time. The abstainers saw their blood glucose levels fall by an average of 16%. Blood glucose is a key factor in the development of diabetes. They also found that those who stopped drinking for 5 weeks lowered their liver fat (seen on ultrasound and blood tests) by 15-20%. Fatty liver is caused by obesity and excessive alcohol intake and is a major health problem and cause of chronic liver disease.

And what about people who want to lose weight, like my beach bound hairdresser? It turns out her "Dry January" was the thing to do. There are about 120 calories in a 5oz glass of white wine. Only 1.5oz of tequila or vodka contains 96 calories. A 12oz bottle of beer is 150 calories. By cutting out alcohol, you eliminate thousands of empty calories. Some abstainers reported more energy and that means more activity, which also sheds pounds.

The researchers don't know if one month off alcohol translates into long term better health. We know from other studies that the key is making changes that last and are part of our lifestyle. Rather than a dry month, it would be better for our health if we cut back on alcohol consumption all year.

Monday, January 18, 2016

The untimely death of Glenn Frey, one of the talented leads in the famous Eagles band, has left his fans saddened and the music industry has lost another great. Early reports from his publicist say his death was from Ulcerative Colitis, Rheumatoid Arthritis and Pneumonia. You may wonder how someone dies of pneumonia in 2016.

At the turn of the Century, before we had antibiotics, pneumonia was considered "the old man's friend". A slight pulmonary infection often led to death and I remember my grandmother saying; "Cover up or you'll catch your death of pneumonia". In her day it was serious and fatal. But now we have effective antibiotics to treat pneumonia and it mainly effects people who are very young, immunocompromised or who have multiple other organ failures. So what may have happened to Mr. Frey?

Both Rheumatoid Arthritis and Ulcerative Colitis are treated with medications that can affect the body's natural immune system. Because they are both "auto-immune" diseases, effective medications turn off the body's cells that cause the disease but these same medications also turn off the white cells and macrophages that fight infection. It is always a delicate balance when we use medications that affect the same cells that cause certain disease flare-ups as well as prevent infection from taking hold.

It is just speculation without knowing Mr. Frey's medical history, but he may have been too immune compromised to fight off the pneumonia...even with the best antibiotics. Rheumatoid Arthritis and Ulcerative Colitis can be life altering themselves, but death from infection (pneumonia) is often what happens if a person is very ill.

It is important for older people or persons with chronic diseases to get a pneumonia vaccine. Babies are also immunized with this vaccine. This vaccine is effective in nearly 100% of Streptococcal Pneumonia strains of bacteria. But there are dozens of other bacteria and viruses that can infect the lungs also and cause pneumonia and in a person who is immunocompromised, as I suspect Glenn Frey was, the body can become overwhelmed with infection and sepsis. Even the most heroic advances in medicine can fail in some cases.

Glenn Frey was a wonderful musician and has left behind a great body of work that continues to bring joy to the listeners. RIP, Mr. Frey

Thursday, January 14, 2016

Statins are the most commonly used medications in the U.S. and are used by millions of people to reduce cardio-vascular disease, heart attacks and stroke. For patients who take the three most commonly prescribed, Simvastatin, Lovastatin and Atorvastatin, the current medical advice is to avoid grapefruit juice while talking these medications. Grapefruits and grapefruit juice increase the concentration of these drugs in the body. But a new study published in The American Journal of Medicine says we have it all wrong! Patients who like grapefruits should go ahead and enjoy them with their statins. Here's what the researchers say:

Fresh grapefruit juice contains bergamottin which has an effect on an intestinal enzyme (CYP3A4 for you chemists) that prevents the breakdown of certain statins. The consequence is that the blood level of these three statins are increased when taken with grapefruit juice. We've known about this interaction since is was discovered by accident in 1989 when researchers were studying another drug that is affected by this enzyme. Since that time, patients have been advised to avoid grapefruit juice. But since we know that standard doses of these medications reduce LDL (bad) cholesterol by 37%, doubling the dose reduces it by 43%. So we should think of grapefruit juice as an enhancer of Statins. Each reduction of LDL in the blood further reduces risk of heart disease.

The perception that grapefruit juice is contraindicated for people on statins is misleading and the conclusion from this study is that it can enhance the positive effects of these three statins. Grapefruits are low in calories and high in Vitamin A and C and with a low glycemic index they have a positive effect on blood sugar. This is good news for people who like grapefruit juice and who take statins.
There is no reason to avoid them.

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About Me

I am an Internal Medicine physician who has practiced for over 30 years in Northern California. I was previously the President of the SF Medical Society and Chief of Staff at a large academic medical center. I am currently the Chief Executive Officer for a large Physician and health care provider group in Northern
California. My practice is smaller now
but caring for patients is still the most important part of my work. I love taking care of patients one:one as well as influencing health care at a larger level.
The information on this site is not designed to replace a physician's advice.
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